Tamoxifen, Raloxifene, and the Prevention of Breast Cancer1
V. Craig Jordan and
Monica Morrow
Departments of Molecular Pharmacology, Biological Chemistry
(V.C.J.), and Surgery (M.M.), Robert H. Lurie Comprehensive Cancer
Center, Northwestern University Medical School, Chicago, Illinois
60611
I. Introduction
II. Lacassagne’s Prevention Principle:A Target and anEstrogen Antagonist
III. Tamoxifen as an AntitumorAgent
A. ER status and the duration of tamoxifen
B. Contralateralbreast cancer
C. Endometrial cancer
D. Conclusions
IV.Selective Estrogen Receptor Modulation
A. Antiestrogen activityat the ER
B. Coactivators for ER
C. Alternate response elementson DNA
D. An alternate ER-ERß
V. Biological Basisfor Tamoxifen as a Breast Cancer Preventive
A. Animal models
B. Bones
C. Lipids
D. Uterus
VI. Risk Factors for BreastCancer
A. Interactions among risk factors
B. Identificationof candidates for chemoprevention
VII. Prevention of BreastCancer with Tamoxifen
A. Royal Marsden Pilot Study
B. NSABP/NCIStudy
C. Italian study
D. Conclusions
VIII. BiologicalBasis for Raloxifene as a Breast Cancer Preventive
A. Antitumoractions
B. Bones
C. Lipids
D. Uterus
IX. Study of TamoxifenAnd Raloxifene (STAR)
X. The Future of Prevention
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